Experience with the chin tuck maneuver in postesophagectomy aspirators

Aspiration is a common finding in the postesophagectomy barium swallow that often necessitates premature termination of the study prior to complete ev aluation of the gastric conduit. More importantly, aspiration may play a si gnificant role in the high incidence of postoperative pulmonary complicatio ns in this population. The chin tuck maneuver is a postural technique that reduces and often eliminates aspiration in swallowing-impaired patients. To evaluate the ability of the chin tuck maneuver to prevent aspiration durin g radiographic examination of the gastric conduit, the technique was used i n 21 esophagectomy patients who aspirated during a swallowing evaluation co mbining the barium swallow and videofluoroscopy. Aspiration was eliminated in 81% of aspirators using the chin tuck maneuver. The results of this stud y demonstrate that the chin tuck maneuver is a simple technique that should be attempted in patients who aspirate postesophagectomy during radiographi c imaging studies that require multiple swallows of contrast materials. Com bining the barium swallow with the videofluoroscopic evaluation of swallowi ng provides objective documentation of both the structural integrity of the gastric conduit and swallowing function in patients after esophagectomies who are at high risk for postoperative morbidity.